Knowledge and Misconceptions about ADHD in School Counsellors in Karnataka: A Cross-Sectional Study

Attention deficit hyperactive disorder (ADHD) is a common neurodevelopmental disorder with cardinal features of inattention, hyperactivity and impulsivity, significantly impacting the child’s daily functioning and overall development (1). In south India, the prevalence of ADHD was reported to be 9.57% (67 out of 700) with mean age of 8.9 years and highest prevalence among children aged 9 to 10 years (2).

Despite its high prevalence, ADHD is often misdiagnosed or underdiagnosed. Studies have identified that girls are more likely to be misdiagnosed than boys. This could be attributed to the tendency to internalize the symptoms due to societal norms, whereas boys are more likely to externalize their symptoms(3,4).This discrepancy results in boys being referred to clinics for neurodevelopmental difficulties, whereas girls are often treated for emotional concerns associated with ADHD (5).

Delayed diagnosis and implementation of early intervention in ADHD can affect the child’s major areas of functioning, such as academic performance and peer relationships, which increases the risk for behavioral problems and school dropout (6–9). Increasing academic demands can result in significant difficulties for them, since these children already encounter a lot of cognitive and behavioral challenges (10). Therefore, early identification and intervention are essential to reduce these challenges and support the development of the child.

However, to make a diagnosis of ADHD, the symptoms need to be present in more than one setting. Since the children spend more time in school, school counsellors who work closely with them could monitor their behavior more comprehensively. Therefore, the knowledge and misconceptions regarding ADHD among counsellors is important to identify the ADHD symptoms and to make necessary referrals. High misconception may result in failure to identify the signs of ADHD in early phase and affect their attitude towards the student (11).

Research has explored the knowledge of both teachers and parents regarding ADHD. These studies have obtained mixed findings in terms of knowledge of teachers about ADHD. Their qualifications also significantly influence their attitude towards children with ADHD (12–14). Similarly, parental knowledge of ADHD has identified insufficient knowledge in parents, which has been linked to poor adherence to treatment (15,16).In response training programs have been developed to improve the awareness of the population (17).

Another essential figure in supporting students within the school setting is the school counsellor. School counsellors play a vital role in understanding the needs of the students and working collaboratively with parents and teachers. They also provide support to teachers by enhancing their awareness and skills to guide students who require additional support. Therefore, it is important for the school counsellor to have a good understanding of developmental issues like ADHD (18).

While previous studies have extensively explored the knowledge of teachers and parents, the knowledge and misconception held by counsellors remains less explored. Hence the present study aims to understand the knowledge and misconceptions about ADHD in school counsellors.